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Journal of Nursing Theory and Practice

FEBRUARY 28, 2017

[Community nurses’ challenges and occupational health hazards associated with home health care]

HIRDI Henriett Éva, LUKÁCS Miklós, BURCSEK Tóthné Ildikó, BALOGH Zoltán

[The aim of the study was to assess the occupational health hazards associated with the delivery of home health care among nurses in family practices. Methods: The cross-sectional survey was conducted between 20 January 2016 and 15 April among nurses working in general, child and family practices, selected using a random, sampling method (N=983). The data gathering took place using a web-based, anonymous, self-completion questionnaire. The authors analysed the gathered data with Microsoft Excel 2013 software, employing a descriptive statistical methods. Results: 99,59% of nurses were female with an average of 27,34 years experience. Nurses reported the following frequently health risks at their client’s homes: 71,4% handling sharp devices or equipment, 54,9% contact with human body fluids, 29,51% smoking in home, 13,7% patient handling without slings or handling devices, 8,9% agressive pets, 7,5% neighborhood violence/crime. Conclusions: Results demonstrated an increased biological health risk among nurses. Based on the results, the authors stress the importance of developing and conducting training programs concerning occupational health hazard issues for nurses working in family practices. ]

Clinical Oncology

DECEMBER 10, 2016

[Long-term central venous access devices in oncology]

PAJKOS Gábor

[Long-term central venous access devices are essential in the management of oncology patients, as they minimize the discomfort caused by frequent venipuncture and cannulation. Indications of application of central venous accesses, possibilities of implantations, immediate and long term complications, they prevention and obviation has been reported based on guidelines and relevant publications. Long term implantable central venous accesses handled by well-trained and exercised team, working with principles of maintenance, these manipulations are effective and safe, therefore suitable in oncological practice.]

Journal of Nursing Theory and Practice

AUGUST 30, 2016

[Application of external circulatory assist device in cases of cardiac failure]

TAMÁS Csilla, BARATI Zoltán

[The Heart and Vascular Centre of Semmelweis University was the first institution in Hungary to routinely apply external mechanical circulatory support (Extracorporal Membrane Oxigenation, Ventricular Assist Device) as a new alternative to treat cardiogenic shock cases. The objective of our study was to assess how frequently certain therapeutic methods were applied, and to evaluate the demographic characteristics, the case historic and the mortality data of the patients treated, as well as to demonstrate the incidence rate of the most frequent complications. Our study was based on the data of patients suffering cardiogenic shocks treated with external circulatory assist devices between 1. June, 2012 and 31. January, 2016. The study has been carried out analytically and retrospectively after data collection from written and electronic patient documentation. Data analysis has been executed by SPSS software. The results revealed uneven gender distribution, over 60% of incidence in case of four examined complications, and an elevated mortality rate of patients over 60 years old. We found that there is a higher risk for complications if mechanical circulatory support is applied, and we made a suggestion to reconsider the application of this support for patients over certain ages. The study demonstrated that our results match the statistical data found in international medical literature. ]

Journal of Nursing Theory and Practice

FEBRUARY 28, 2016

[About Therapy Data Management System (TDMS) by nurses]

SOMOSI László, LADÁNYI Erzsébet

[Recently, the precise management of dialysis-related documentation has become a big responsibility and burden. As a result, less time is available to perform daily nursing tasks. Therefore, our company has introduced the Therapy Data Management System (TDMS) at 10 dialysis centres. The system was developed to reduce the administrative burden and provide information to the staff about the current dialysis session. The TDMS loads the dialysis treatment prescription from the data recording programme used in our network to the dialysis machine. Two main elements are used: data base for treatment monitoring and current treatment parameters. The database for treatment monitoring is used for data input (using the computers in the unit), while the current treatment parameters are used as data input to the dialysis devices and for data documentation. Patients are identified by patient identification cards recording weight before and after the dialysis session. The programme automatically calculates the current ultrafiltration, but data can be modified if necessary. After loading and validating the parameters, treatment can be initiated. With the introduction of the TDMS the time spent for documentation was reduced by 15-20 minutes per patientshift and nurse. Dialysis can be started more easily and quickly, because the parameters of the current treatment always appear on the screen. Moreover, the risk of administration errors is reduced. This system effectively supports the daily work in clinical practice. It provides quick and easy access for all users of the management of haemodialysis patient. Keywords: dialysis, data recording, Therapy Monitor, TDMS ]

Clinical Neuroscience

JULY 30, 2016

Syndrome of trephined-underestimated and poorly understood complication after decompressive craniectomy

LÁNG József, GANAU Mario, PRISCO Lara, BOZSIK Krisztina, BANCZEROWSKI Péter

Decompressive craniectomy (DC) is still a matter of debate, with a numerous complications as expansion of haemorrhagic contusions, external cerebral herniation, subdural hygromas, post-traumatic hydrocephalus (HC). The often overlooked “syndrome of the trephined” (ST) as a delayed complication of DC also known as sinking skin flap sy initially described in 1939.ST is characterised by the neurological changes associated with alteration of the pressure/volume relationship between intracranial pressure (ICP), volume of cerebrospinal fluid (CSF), blood, and brain tissue in patients with large bone defects. This review aims at elucidating the mechanisms responsible for the development of ST, and providing useful tips and red-flag signs for healthcare professionals involved with care of post DC patients. Symptoms identified on time could help to develop appropriate treatment strategies for this suddenly deteriorating, but possible reversible condition. Although the treatment strategy is straightforward, calling for a prompt cranioplasty, the correction of HC through CSF diversion devices might require a lengthy optimisation period. Continuous changes in the setting of the shunting systems or spinal tap might lead to dangerous swinging of the midline structures causing further neurological deterioration. Thus, finding the right balance in terms of clinical management often represents a significant challenge.

Clinical Neuroscience

MAY 30, 2016

[New opportunities in neuro-rehabilitation: Robot mediated therapy in conditons post central nervous system impairments]

FAZEKAS Gábor, TAVASZI Ibolya, TÓTH András

[Decreasing the often-seen multiple disabilities as a consequence of central nervous system impairments requires broadening of the tools of rehabilitation. A promising opportunity for this purpose is the application of physiotherapy robots. The development of such devices goes back a quarter of century. Nowadays several robots are commercially available both for supporting upper and lower limb therapy. The aim is never to replace the therapists, but rather to support and supplement their work. It is worthwhile applying these devices for goal-oriented exercises in high repetition, which one physically fatiguing for the therapist or for the correction of functional movement by various strategies. Robot mediated therapy is also useful for motivation of the patient and making the rehabilitation programme more versatile. Robots can be used for assessment of the neuromotor status as well. Several clinical studies have been executed in this field, all over the world. Meta-analyses based on randomized, controlled trials show that supplementing the traditional physiotherapy with a robot-mediated component presents advantage for the patients. Further studies are necessary to clarify which modality and intensity of the exercises, in which group of patients, in which stage lead to the expected outcome.]

Clinical Oncology

FEBRUARY 10, 2015

[Molecular diagnostics of brain tumors - an up-date]

REINIGER Lilla, HANZÉLY Zoltán, BÁLINT Katalin, TURÁNYI Eszter

[In recent years there have been major advancements in the understanding of molecular events driving brain tumor genesis and progression. Although state-of-the-art techniques are not widely available, many of the molecular discoveries lead to novel antibodies that can assist in identifying the major molecular subgroups by immunohistochemistry. Molecular informations will likely be incorporated into the next World Health Organization (WHO) classifi cation of central nervous system tumors, but clinical practice in many centres have already taken on the available informations and therapeutic decisions are made based on genetic/epigenetic information. In the adult population IDH, ATRX and 1p/19q codeletion studies help to defi ne molecular subgroups that correlate better with prognosis and therapeutic response than traditional histology based diagnosis. The KIAA1549-BRAF fusion gene is a hallmark for pilocytic astrocytomas, while diffuse pediatric gliomas lack the IDH mutations and 1p/19q codeletions that are common in adult astrocytomas and oligodendrogliomas. Uncommon in adults, Histone H3.3 mutations are pathognomic in pediatric brainstem malignant gliomas. Molecular subgroups of medulloblastomas have also been identifi ed, and a corresponding set of antibodies are ready to guide treatment decisions in those centres where molecular techniques are not available. These genetic and epigenetic events determine a tumor’s behaviour, and integrating this level of informations into neuropathology practice is essential to provide the best possible care to both pediatric and adult patients.]

Journal of Nursing Theory and Practice

JUNE 30, 2015

[History of operating room nursing profession]

PÉCZELI András

[Complete personal and material condition are foundations of operation. Surgical assistant (scrub nurse) is indispensable part of surgical group of workers who has significant role in direct operation beside preparation and after operation periods. Qualified scrub nurse instrumentation to surgeon who operates and to his assistant which required perfect knowledge of every means and materials. Technical development result in change of surgery’s repertoire: new tipes of procedures and devices. Surgical assistants have to be abreast with developments, with changing working environment, qualification and laws. Author represent the history of surgical assistant work from the begining to nowadays. Author demonstrate advent of surgical assistant profession, change of vocational training and attached laws, exercises of scrub nurse at the present time and in the past. ]

Clinical Neuroscience

JANUARY 25, 2013

[Experiences with a self developed accelerometer]

VÉR Csilla, HOFGÁRT Gergely, SZIMA Gábor, KOVÁCS GÁBOR, NYISZTOR Zoltán, KARDOS László, CSIBA László

[Objective - In neurology the objective evaluation of improvement of paresis on every-day practice. The aim of this study was to develope and test a small 3-d acceleration measuring device and validate its usefulness. Patients and methods - We collected data from 17 mild and medium severity hemiparetic, bedridden acute ischaemic and hemorrhagic stroke patients and compared with data of 22 control subjects. The devices were attached to the paretic and non-paretic extremities and any movements (m/s2) and movement-durations were registered (24h). The data of movement-monitors were compared also with the changes of National Institute of Health Stroke Scale and European Stroke Scale. The electromiograph-sensor of polysomnograph has been used for validation. Results - Mild differences could be found in the use of dominant and non-dominant upper extremities of control persons. The control persons used their upper extremities more frequently than the stroke patients. Our data showed significant correlation with National Institute of Health Stroke Scale. Higher values on the scores were accompanied with less intensive use of extremities. We found a correlation between the consiousness level of patients and their activity of upper extremities. If the patients had severe consiousness disturbances they used significantly less their upper extremities. Conclusion - Our device sensitively detected the movement-differences between paretic and non-paretic extremities and can be used for quantitative evaluation of patient's neurological and consciousness status.]

LAM Extra for General Practicioners

DECEMBER 15, 2012

[THE SENSOR-AUGMENTED INSULIN PUMP AND ITS USE IN CLINICAL PRACTICE]

KÁNTOR Irén

[Diabetes is one of the most common chronic diseases. Technological advances provide increasingly refined tools for clinicians to manage type 1 and type 2 diabetes. Continuous subcutaneous insulin infusion (CSII), also known as insulin pump, allows for a sophisticated delivery of basal as well as bolus insulin. Continuous glucose monitoring helps patients and clinicians understand and manage changes in blood glucose trends and minute-to-minute blood glucose variablitiy. The sensor-augmented insulin pump was created by the merging of these devices, which has been a revolutionary step towards self-regulatory, closed-loop insulin delivery or the creation of an artificial pancreas.]